Provider Demographics
NPI:1386615169
Name:ROMRELL, NATALIE (LCSW)
Entity type:Individual
Prefix:
First Name:NATALIE
Middle Name:
Last Name:ROMRELL
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:195 WEST 7200 SOUTH
Mailing Address - Street 2:
Mailing Address - City:MIDVALE
Mailing Address - State:UT
Mailing Address - Zip Code:84047-1020
Mailing Address - Country:US
Mailing Address - Phone:801-578-8500
Mailing Address - Fax:801-578-8470
Practice Address - Street 1:195 WEST 7200 SOUTH
Practice Address - Street 2:
Practice Address - City:MIDVALE
Practice Address - State:UT
Practice Address - Zip Code:84047-1020
Practice Address - Country:US
Practice Address - Phone:801-578-8500
Practice Address - Fax:801-578-8470
Is Sole Proprietor?:No
Enumeration Date:2006-01-30
Last Update Date:2011-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT519096535011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT942938348RMMOtherEDUCATORS MUTUAL
UT107040214101OtherINTERMOUNTAIN HEALTH CARE
UT51909653500001OtherBLUE CROSS
UT907900OtherDESERET MUTUAL